Yin Yutian, Han Weiqing, Wang Yuhan, Zhang Yue, Wu Shili, Zhang Huiping, Jiang Lingling, Wang Rui, Zhang Peng, Yu Yaqin, Li Bo
Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, Jilin 130021, China.
Administration Bureau of Changbai Mountain Natural Mineral Water Source Protection Areas, Jilin 130021, China.
Int J Environ Res Public Health. 2015 Oct 12;12(10):12662-78. doi: 10.3390/ijerph121012662.
Besides genetic factors, the occurrence of diabetes is influenced by lifestyles and environmental factors as well as trace elements in diet materials. Subjects with impaired fasting glucose (IFG) have an increased risk of developing diabetes mellitus (DM). This study aimed to explore risk factors affecting IFG and diabetes in patients from Northeast China.
A population-based, cross-sectional survey of chronic diseases and related risk factors was conducted in Jilin Province of Northeast China. All adult residents, aged 18-79, were invited to participate in this survey using the method of multistage stratified random cluster sampling. One hundred thirty-four patients with IFG or DM and 391 healthy control subjects were recruited. We compared demographic factors, body size measurements, healthy-related behaviors, and hair metallic element contents between IFG/diabetes patients and healthy individuals.
IFG/diabetes patients had a greater weight, waist, hip, and body mass index (BMI) than control subjects. Significant differences in the content of zinc (Zn), potassium (K), copper (Ca), and sodium (Na) as well as Cu/Zn ratios between IFG or DM patients and control subjects (p < 0.05) were also observed. Hair Cu, selenium (Se), and Na contents were positively correlated with blood glucose levels (Cu: rs = 0.135, p = 0.002; Se: rs = 0.110, p = 0.012; Na: rs = 0.091, p = 0.038). Polytomous logistic regression adjusting for age, sex, family history of diabetes and BMI, showed that subjects with high BMI were more likely to develop IFG and DM (IFG: OR = 1.15, OR 95% CI = 1.02-1.29; DM: OR = 1.15, OR 95% CI = 1.01-1.33). Moreover, rarely or never eating fruits was a risk factor for DM (OR = 5.46, OR 95% CI = 1.87-15.98) but not for IFG (OR = 1.70, OR 95% CI = 0.72-4.02). Subjects with abdominal obesity or DM history were more susceptible to DM (abdominal obesity: OR = 2.99, OR 95% CI = 1.07-8.37; DM history: OR = 2.69, OR 95% CI = 1.01-7.20). We found that subjects living in Changling County had a significantly lower chance to suffer from IFG (OR and 95% CI for OR: 0.25, 0.08-0.74). Men and 60-69 years old subjects were at increased risk for IFG (male: OR = 3.51, OR 95% CI = 1.34-9.18; age 60-69: OR = 6.64, OR 95% CI = 1.36-32.47). We did not find significant associations of IFG or DM with certain lifestyles (such as eating more meat, exercise or physical activity, smoking, or alcohol drinking) or the content of some metallic elements (such as iron (Fe), Zn , K, calcium (Ca), Na, or magnesium (Mg)).
This study demonstrated that less or no fruit eating, DM family history, abdominal obesity conferred vulnerability to DM. Living in Changling County, men and 60-69 years old subjects were found to be risk factors for IFG. Subjects with high BMI were more likely to develop IFG and DM.
除遗传因素外,糖尿病的发生还受生活方式、环境因素以及饮食材料中的微量元素影响。空腹血糖受损(IFG)患者患糖尿病(DM)的风险增加。本研究旨在探讨影响中国东北地区患者IFG和糖尿病的危险因素。
在中国东北地区的吉林省开展了一项基于人群的慢性病及相关危险因素横断面调查。采用多阶段分层随机整群抽样方法,邀请所有年龄在18 - 79岁的成年居民参与本调查。招募了134例IFG或DM患者以及391例健康对照者。我们比较了IFG/糖尿病患者与健康个体之间的人口统计学因素、身体尺寸测量值、健康相关行为以及头发金属元素含量。
IFG/糖尿病患者的体重、腰围、臀围和体重指数(BMI)均高于对照组。IFG或DM患者与对照组之间锌(Zn)、钾(K)、铜(Ca)和钠(Na)的含量以及铜/锌比值也存在显著差异(p < 0.05)。头发铜、硒(Se)和钠含量与血糖水平呈正相关(铜:rs = 0.135,p = 0.002;硒:rs = 0.110,p = 0.012;钠:rs = 0.091,p = 0.038)。在对年龄、性别、糖尿病家族史和BMI进行校正的多分类逻辑回归分析中,发现高BMI受试者更易发生IFG和DM(IFG:OR = 1.15,OR 95% CI = 1.02 - 1.29;DM:OR = 1.15,OR 95% CI = 1.01 - 1.33)。此外,很少或从不吃水果是DM的一个危险因素(OR = 5.46,OR 95% CI = 1.87 - 15.98),但不是IFG的危险因素(OR = 1.70,OR 95% CI = 0.72 - 4.02)。腹型肥胖或有DM病史的受试者更易患DM(腹型肥胖:OR = 2.99,OR 95% CI = 1.07 - 8.37;DM病史:OR = 2.69,OR 95% CI = 1.01 - 7.20)。我们发现居住在长岭县的受试者患IFG的几率显著较低(OR及OR的95% CI:0.25,0.08 - 0.74)。男性以及60 - 69岁的受试者患IFG的风险增加(男性:OR = 3.51,OR 95% CI = 1.34 - 9.18;60 - 69岁:OR = 6.64,OR 95% CI = 1.36 - 32.47)。我们未发现IFG或DM与某些生活方式(如多吃肉、运动或体育活动、吸烟或饮酒)或某些金属元素(如铁(Fe)、锌、钾、钙(Ca)、钠或镁(Mg))含量之间存在显著关联。
本研究表明,少吃或不吃水果、糖尿病家族史、腹型肥胖会增加患DM的易感性。居住在长岭县、男性以及60 - 69岁的受试者被发现是IFG的危险因素。高BMI受试者更易发生IFG和DM。